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Cognitive Therapy for Depression

Are your thoughts dragging you down?
WebMD Feature

Almost everyone has dark thoughts when his or her mood is bad. With depression, though, the thoughts can be extremely negative. They can also take over and distort your view of reality.

Cognitive therapy can be an effective way to defuse those thoughts. When used for depression, cognitive therapy provides a mental tool kit that can be used to challenge negative thoughts. Over the long term, cognitive therapy for depression can change the way a depressed person sees the world.

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Studies have shown that cognitive therapy works at least as well as antidepressants in helping people with mild to moderate depression. Treatment with medication and/or psychotherapy can shorten depression's course and can help reduce symptoms such as fatigue and poor self-esteem that accompany depression. Read on to see how cognitive therapy or talk therapy might help you start thinking and feeling better if you are depressed.

Cognitive Therapy for Depression: A Thinking Problem

Cognitive therapy was developed in the 1960s as an alternative way to treat depression, says Judith S. Beck, PhD. Beck is director of the Beck Institute for Cognitive Therapy and Research located outside Philadelphia. She tells WebMD that the principle underlying cognitive therapy is "thoughts influence moods."

According to cognitive therapists, depression is maintained by constant negative thoughts. These thoughts are known as automatic thoughts. That means they occur without a conscious effort. For example, a depressed person might have automatic thoughts like these:

  • "I always fail at everything."
  • "I'm the world's worst mother."
  • "I am doomed to be unhappy."

Beck says automatic thoughts "may have a grain of truth. But," she adds, "the depressed person distorts or exaggerates the reality of the situation." This negative distortion helps fuel the depression.

With cognitive therapy, a person learns to recognize and correct negative automatic thoughts. Over time, the depressed person will be able to discover and correct deeply held but false beliefs that contribute to the depression.

"It's not the power of positive thinking," Beck says. "It's the power of realistic thinking. People find that when they think more realistically, they usually feel better."

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